Pregnancy And Hematoma – Causes, Symptoms, Treatment

A Hematoma is a localized collection of blood, or clotting, which occurs outside the blood vessels in a tissue or organ. Subchorionic hematoma is the gathering of blood between the membranes of the placenta and the uterus. Subchorionic hematoma usually manifests itself in the early stages of pregnancy. With the help of ultrasound technology, it is easier to detect a subchorionic hematoma. The clot appears as a black mass within the uterus.

In women with subchorionic hematoma, the outcome depends on the size of the hematoma, the mother’s age, and the fetus’s age. If it is small or moderate in size, the subchorionic hematoma often regresses. The clot either bleeds itself out or the body absorbs it. However, if the hematoma is large in size, it strips away at least 30% to 40% of the placenta away from the endometrium. If it goes undetected and continues to grow, it may lead to a premature rupture of the membranes. It can also release completely from the uterus and cause the fetus and placenta to miscarry.

There is no known cause for a subchorionic hematoma but sometimes during egg implantation, the egg might slightly separate from the uterus causing a bleed. There is no prevention for this and women of all ages and races can be affected by this condition.

Most patients with a small subchorionic hematoma are asymptomatic. Common manifestations in the first and second trimester include vaginal bleeding, abdominal pain and premature labor. Vaginal bleeding is the most common symptom of subchorionic hematoma. Thus, if you are experiencing vaginal bleeding in the early months of your pregnancy, getting an ultrasound is highly advisable. However, as the blood passes vaginally, it might sometimes not collect in the subchorionic space. If this is the case, then the hematoma is small and should not pose a threat.

Symptoms of subchorionic hematoma in the latter stages of pregnancy are more severe and tend to include a painful and tense uterus and fetal distress. There is no formal treatment for subchorionic hematoma. However, blood thinners such as aspirin are commonly used to attempt to bleed the clot out. Anti-coagulants are sometimes used for this as well. Women with subchorionic hematoma can also be given extra estrogen and progesterone to aid in the development of the fetus.

Straining and heavy lifting should be avoided, as is the case for a normal pregnancy. While some doctors might advise to you to rest, others might suggest carrying on with everyday activities. Some physicians might even suggest refraining from sexual intercourse during the length of the pregnancy.

What is hematoma during pregnancy?

If a doctor has to tell any pregnant woman that she is suffering from “hematoma in the uterus” or “subchorionic hematoma in the uterus”, it is only natural for her to hit the panic button and assume the worst. At times, the condition is also referred to as “subchorionic hemorrhage in the uterus”, which doesn’t really sound any better. But it is mainly the fear of the unknown that can make any condition seem much worse than what it actually is. Hence by trying to understand what hematoma in the uterus during pregnancy means, a woman could be better prepared to deal with it in the right manner.

A subchorionic hematoma in the uterus during pregnancy can be described as a sort of a blood clot that can be seen in between the pregnancy membranes and the uterus wall. Hematoma pregnancy bleeding occurs when a few parts of the pregnancy membranes get separated from the uterus. The exact reasons for this affliction are still not clear and there is no evidence to state that this takes places because of something that the mother does (or does not do). Fortunately, it is not very common for a woman to suffer from a subchorionic hematoma in the uterus while pregnant, as this problem occurs in only about 1% of the total pregnancies. However, in spite of the fact that hematoma is not a condition that can be treated lightly, it does not always mean that a woman is destined to face an unhappy outcome. It is important to realize that there are some women who do suffer from hematoma in the uterus while pregnant, but they still go on to have normal and healthy babies.

Causes and complications of hematoma in the uterus in pregnancy

The exact causes of early pregnancy hematoma are still not clear, but many doctors believe that at the time of implantation, if the egg separates or tears away from the uterus, it could lead to bleeding in the uterus. Nothing a woman does could lead to or even prevent this occurrence from taking place. Women of all ages, races, levels of fitness and so on can experience subchorionic hematoma in the uterus while pregnant. Studies indicate that if a woman has hematoma in her uterus while pregnant, then the risks of a miscarriage can increase in such a pregnancy. Miscarriage risks are higher in case of an early pregnancy hematoma or if the hematoma is large in size. A hematoma in the uterus that is small in size may not have a drastic effect on the pregnancy or the baby. Apart from a miscarriage, complications that can arise from a large hematoma in the uterus are a preterm labor or growth restriction in the baby.

Signs and symptoms subchorionic hemorrhage

One of the most common subchorionic hematoma symptoms in a pregnant woman is bleeding. The amount and the severity of the bleeding could differ from one woman to the other, wherein some women may see light spotting, while others may experience a heavy flow of blood, perhaps with blood clots present too. Unfortunately, if a woman experiences a high amount of vaginal bleeding due to hematoma, she may receive a diagnosis of a threatened miscarriage. Although this sounds very scary, several women have had threatened miscarriages, but have still had viable pregnancies. Apart from bleeding, some of the other symptoms of subchorionic hemorrhage include pain and cramps in the abdominal area. In some cases, there may be no outward subchorionic hematoma symptoms experienced by a woman at all and the condition is only diagnosed if the doctor conducts a routine ultrasound to check the overall health and development of the baby.

Treatment

Unfortunately, there is no specific or formal treatment that is administered for women who suffer from hematoma in the uterus while pregnant. Most doctors suggest taking it easy and getting a lot of bed rest; however, some doctors also advise pregnant women who have hematoma, to continue their normal day to day activities. However, almost all pregnant women, who have a hematoma in their uterus while they are pregnant, are asked to refrain from engaging in any taxing or strenuous physical activity. Therefore, lifting weights, walking too fast or engaging in sexual intercourse should not even be considered by women who have hematoma while pregnant.

The approach taken by various doctors to treat hematoma in uterus during pregnancy could differ from one pregnancy to the other, based on the mother’s overall health and medical condition. Some doctors may just decide to “wait and watch”, as the mother takes complete bed rest. However, other doctors may prefer prescribing blood thinners, like aspirin, in an attempt to allow the clot to bleed out. The woman is also usually advised to drink a lot of water, so that her body remains well hydrated. Dehydration could make the uterus contract, which can irritate the baby and aggravate the blood clot at the same time.

Studies indicate that with conditions that are carefully monitored by a doctor, the clots generally get resolved on their own, without any vaginal hematoma treatment being required. Within the 20th week of pregnancy or so, the clot should either be absorbed by the body, or it should bleed out completely. In fact, it has been seen that the “bleeding out” effect is felt by women with hematoma, at regular intervals, during the entire course of pregnancy, in the form of vaginal bleeding. At times, abdominal cramps may also be felt. Pain, cramps and bleeding are very scary for pregnant women, in spite of the fact that they are normally associated with subchorionic hematoma in the uterus. The best way to deal with them is by getting a lot of rest and avoiding any form of physical and mental stress.

Apart from following the doctor’s advice carefully, women who have been diagnosed with subchorionic hematoma in the uterus while pregnant are also usually encouraged to join support groups and forums which have become quite common over the last few years. Most such groups provide online support too, so that the woman does not have to leave the comfort of her home or even get up from the bed, in order to get her queries answered. However, in case of any doubt, the first person that a woman should contact is her doctor.